US adolescent nutrition, exercise, and screen time baseline levels prior to national recommendations

Experts have recommended daily obesity prevention goals: ≥5 fruits/vegetables, <2 hours of screen time, >1 hour of physical activity, and no sugar-sweetened beverages (5-2-1-0). The authors analyzed National Health and Nutrition Examination Survey data for 1999-2002 to determine the proportion of US adolescents (12-19 years) who would have met each goal prior to dissemination of the 5-2-1-0 recommendations. Merely 0.4% would have met all goals; 41% would have met none. Only 9% consumed ≥5 fruits/vegetables, 27% reported <2 hours of screen time, 32% had >1 hour of physical activity, and 14% consumed no sugar-sweetened beverages per day. Demographic subgroups (eg, racial/ethnic minority and lower income) would have been even farther from meeting the goals. Clinicians are likely to encounter adolescents with nutrition, exercise, and screen time behaviors that are far from 5-2-1-0 goals, and can use these guidelines during clinical encounters to counsel adolescents regarding healthier lifestyles.